Essential Functions:

• Responsible for assignment of diagnosis/procedure codes using ICD 10 CM/PCS, CPT/HCS in various settings and for a wide range of ages from neonate to geriatric utilizing the OPTUM encoder.
• Validates coding accuracy using clinical information found in the health record
• Interprets health record documentation using knowledge of anatomy, physiology, clinical disease processes, pharmacology, and medical terminology to support the diagnosis and reflect clinical findings, and discharge status of patient.
• Consults with providers through queries to obtain further clinical information to assist with code assignment.
• Validates reimbursement classification system assignments.
• Assists in the facility’s billing process.
• Utilizes common software packages such as spreadsheets, information systems and e-mail.
• Understands the role of various providers and disciplines throughout the continuum of care.
• Spends 95% of the time completing coding functions.
• Participate in facility-wide adherence to health information services regulatory requirements.
• Verify DRG assignment based on PPS definitions and APC assignment based on OPPS definitions.
• Performs E/M coding and charge capture for both the facility and physician.
• Assist with education of physicians and staff regarding reimbursement methodologies and documentation rules and regulations related to coding.
• Recognize UB data elements and manage unbilled, denied or suspended accounts.
• Apply reimbursement methods for billing or reporting; interpret LMRP or payer policies to determine coverage. ​​​​​​

• Ability to communicate clearly and effectively with all levels.
• Ability to complete competency for CCS and CPC.
• Ability to perform simple mathematical equations.
• Ability to prioritize and complete multiple tasks simultaneously.
• Effective oral and written communication skills.

Working Conditions:

• Exposure to distressed patients, families or visitors.
• Possible exposure to inside environmental conditions.

Physical Demands:

• Requires standing, sitting or walking for up to 8 hours or longer per day.
• The ability to lift up to 50 lbs.

Requirements:

• CCS, CPC, A & P required.
• High school graduate or equivalent.
• Experience with medical terminology.
• Experience in clinic coding. 

Preferred Requirements:

• 2+ years of experience
• 2 or 4 year Degree